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Have abdominal hernia due to fatty tissue. Noticed blood in stool. Prescribed meloxicam. Required treatment?

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A few days ago I was seen in the emergency room for stomach paon at the belly button site it was derermined after a CT scan of my abdomen that I have abdominal hernia due to fatty tissue. Doc said surgery was not necessary and it would go away eventually I was prescribed Meloxicam anti inflamm drug. However today it appears that something ..maybe one of the soft spots protruding out of my belly button burst and has a smell of bowl. It is ouss like with small traces of blood. I called same doc who treated me and got the PA who said it may be just and infection and called in script for an antibiotic. I do not inderstand what could have burst and why is surgery not needed to stop this pain swelling and discharge. Will this really go away on its own? The PA said I dont need to come in and be seen again.
Posted Fri, 12 Apr 2013 in Abdominal Pain
Answered by Dr. Grzegorz Stanko 14 minutes later

Thank you for the query.

I can see 3 possibilities of such symptoms.
1. Umbilical hernia with omentum (fatty tissue) necrosis.
2. Urachal cyst - connection between the urinary bladder and umbilicus (usually it disappears after a birth).
3. Intestinal fistula.

1. Umbilical hernia seems to be confirmed with abdominal CT, however most of the people do have little hole in the belly button area. You do have hernia if any lump appears in the umbilicus, and the pain aggravates while coughing or pushing on stool.
2. Urachal cyst is possible if you do have urinary tract infections from time to time, the discharge from the umbilicus smells really bad (like urine) and there is an inflammation of the surrounding tissues.
3. Intestinal fistula is a pathological connection between the skin and intestine due to inflammatory bowels disease. It is possible if there is a gas and brown or yellow discharging from this area.

All 3 possibilities needs general surgeon attention. Abdominal wall ultrasound can be more accurate than abdominal CT.

Hope this will help. Feel free to ask further questions.
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